危重症患者早期液体复苏对腹内压的影响

目的探讨危重症患者早期液体复苏对腹内压的影响。方法选择2010年1月～2011年5月长治市人民医院重症医学科收治的危重症患者32例,随机分为两组。在常规治疗方法基础上,实验组采用适度液体复苏,对照组采用快速大容量液体复苏。应用膀胱测压法监测两组患者腹内压力变化情况,比较两组患者扩容达标时间、平均输液速度、液体潴留总量、腹腔压力变化。结果对照组患者扩容达标时间明显低于实验组(,P<0.01);对照组平均输液速度、液体潴留总量明显高于实验组,(P<0.05);对照组腹内压显著高于实验组,(P<0.05)。结论危重症患者早期液体复苏时要密切监测腹内压力变化,既要解决血容量缺失问题,又要避免组织液体潴留,减少腹腔间隔综合征等并发症。

Objective Discussion on early fluid resuscitation in critically ill patients with intra-abdominal pressure effect.Methods From January 2010 to May 2011,32 patients in intensive care unit were randomLy divided into control group and test group. Based on the conventional treatment method, the test group was treated with appropriate fluid resuscitation the control group was used with rapid, large-volume fluid resuscitation. Application of bladder pressure monitoring in two groups of patients with intra-abdominal pressure changes.Compared the average time of expansion up to standard,infusion speed, fluid retention and intra-abdominal pressure changes of patients in two groups.Results In the control group,the fluid expansion time was significantly lower than in the test group （P 〈 0.01 ）;the average speed of infusion,fluid retention volume were significantly higher in the control group than in the test group（P〈0.05）;the intra-abdominal pressure in the control group was significantly higher than that in the test group（P〈0.05）. Conclusion In critically ill patients with early fluid resuscitation to closely monitor the intra-abdominal pressure changes.It is necessary to resolve the problem of the lack of blood volume, but also avoid the tissue fluid retention,reduce the complications such as abdominal compartment syndrome.